Preoperative determination of screw length and screw thickness with three-dimensional CT assistance in patients which are planning percutan retrograd column screw in acetabulum anterior column fractures

Aim: In this study, measuring the length and thickness of the screws for percutaneous retrograde fixation in acetabulum anterior column fractures with three-dimensional computed tomography,It was aimed to reveal the difference of these measurements between the genders.In addition, it was aimed to evaluate the effect of the angle between the anterior column and ramus pubic superior on the screw thickness. Material and Method:A retrospective study of 384 patients without pelvic pathology, who underwent pelvic computed tomography at Dicle University Hospital between 2016–2021, was retrospectively analyzed.384 patients with appropriate radiological data were included in the study.After radiological evaluation of the patients, appropriate level incisions were made in the ramus pubic superior and anterior column.. Screw length and screw thickness were measured from these incisions.Angles between the acetabulum anterior column and ramus pubis superior were measured.We measured the angles of the screw axis with the sagittal and coronal planes during screw delivery. Results:In our study, 384 hemipelvis were examined.Of the patients included in the study, 174 (45.3%) were female and 210 (54.7%) were male.The average age is 48.18. The mean age for women was 46.4, and the mean age for men was 49.5.The screw diameter to be used was measured as 4.38mm in men and 4mm in women.We found the screw length to be 116.5 for males and 103.6 for females.The angle of the screw to be sent with the coronal plane was 61 degrees, and the angle with the sagittal plane was 31 degrees.The angle between the anterior column of the acetabulum and the superior ramus pubis was similar in men and women and was measured as 157.The differences in screw diameter between men and women were statistically significant (p<0.05).There is a significant relationship between the angle of the acetabulum anterior column and the ramus pubis superior plot and the screw diameter.However, this angle does not differ statistically between men and women. Conclusion:When evaluating the screw diameter to be sent, the difference between male and female gender should be considered.In addition, the diameter of the screw to be sent increases as the angle between the anterior column of the acetabulum and the superior ramus pubis increases.The angle of the screw to be sent with the coronal and sagittal plane should be determined by preoperative computed tomography. Key Words:Acetabulum, anterior column, ramus pubis superior, retrograde, sagittal angle, coronal angle, percutaneous, fixation, minimally invasive